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General NPI Number Information
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NPI Number | 1518802404
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Entity Type | Organization
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Legal Business Name | OASIS HEARING CARE OF ORANGE PARK LLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 1494 PARK AVE STE 1494
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City | ORANGE PARK
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State | FL
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Zip | 32073-4908
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Country | US
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Telephone | 904-644-8779
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Fax |
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Provider Business Mailing Address
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Address Line | 9611 CUSTER RD APT 1936
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City | PLANO
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State | TX
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Zip | 75025-6564
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE MANAGER
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Name | MR. ROGER MC KEE HANSEN JR.
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Credential |
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Telephone | 212-444-8552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2355A2700X
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Taxonomy Name | Audiology Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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